Background: Central sensitization has been suggested as an explanation of the wide range of gastrointestinal and extraintestinal symptoms commonly seen in irritable bowel syndrome (IBS). In this study, the presence and level of central sensitization, and its association to gastrointestinal (GI) symptoms were explored in IBS in comparison with control groups. Methods:We investigated patients with IBS (n = 215), chronic pain disorders (n = 36), and inflammatory bowel disease (IBD) (n = 40) and volunteers without chronic diseases (n = 112). The Central Sensitization Inventory (CSI) was translated and validated in Swedish and used together with the Highly Sensitive Person (HSP) scale to measure the presence and level of central sensitization. Furthermore, severity of GI symptoms (GSRS-IBS and IBS-SSS), and anxiety and depression (HAD) were determined. Key results:The Swedish translation of CSI demonstrated excellent validity. Central sensitization, defined by validated cut-off levels for CSI and HSP, was common in the whole cohort (40% and 28%) and in IBS (57% and 35%). Study participants with central sensitization had more severe GI symptoms, anxiety and depression, than participants without central sensitization. Strong associations were seen between CSI and GI symptom severity in the whole cohort (GSRS-IBS: partial η 2 = 0.455, p < 0.001; IBS-SSS: partial η 2 = 0.408, p < 0.001), with decreasing strength in patients with chronic pain, IBD, IBS, and volunteers. Conclusion and Inferences:Central sensitization was common in IBS and associated with GI symptom severity, but with stronger associations in chronic pain disorders and IBD. This implies that other mechanisms may be of equal or greater importance for GI symptom severity in IBS.
Die literarhistorische Bedeutung, die Ciceros De oratore für die Geschichte der Fazetie gehabt hat, ist gerade in letzter Zeit wieder hervorgehoben worden 1 ). Die in den Abschnitten 216-290 des zweiten Buches entwickelten Vorstellungen bilden die erste zusammenhängende Theorie des Witzes und des Komischen in der europäischen Literatur. Zudem sind sie sowohl in ihrer spezifischen literarischen Form des Symposions als auch in ihrem Gehalt bis weit in die Neuzeit von stärkster Wirkung geblieben 2 ). Einen sehr viel geringeren Widerhall haben hingegen die Beispiele gefunden, mit denen Cicero seine theoretischen Ausführungen belegt. Der Grund dafür liegt offenbar darin, daß die meisten der insgesamt siebzig Witze entweder durch ihre Zeitbedingtheit von der Nachwelt nicht verstanden wurden oder sich wegen der darin enthaltenen Wortspiele einer Übertragung in die Vulgärsprachen widersetzten.Eine Ausnahme bildet jedoch die Fazetie von der Frau im Feigenbaum, die Cicero als Beispiel für einen andeutenden Witz erzählt: Salsa sunt etiam, quae habent suspicionem ridiculi absconditam, quo in genere est Siculi illud, cui cum familiaris quidam quereretur quod diceret uxorem suam suspendisse se de ficu, 'amabo te', inquit, 'da mihi ex ista arbore quos seram surculos' 3 ).Dieser Witz bedarf zum Verständnis seiner makabren Hintergründigkeit keinerlei historischer Vorkenntnisse des Lesers. Er ist zeitlos und könnte ebensogut in jeder modernen Sammlung des schwärzen Humors erscheinen. In der Tat hat er in der abendländischen Literatur eine sehr weite Verbreitung gefunden. Es ist nicht ohne Reiz, an seinen verschiedenen Gestal-
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